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Sunday, February 18, 2018

What The Government Knows About The Next Pandemic Flu: 2 Million U.S. Fatalities Likely

While not a pleasant thought to have running in your mind daily, we are as a world fighting the clock on borrowed TIME for a massive influenza pandemic.  The last major pandemic was in 1918-1919 which killed millions;  650,000 Americans alone.

The next pandemic will have more fatalities, more than double, than the U.S. fatalities of all of the wars the US has experienced since 1776.  That means the US Government is expecting 2,000,000 (that's 2 million) fatalities from the next pandemic.  This report will give the reader insight as to what was actually reported to Congress, and what the average citizen may expect (US DoD).

Fast Facts:

- Pandemic Influenza is NOT the same as "seasonal flu"
- Pandemic Influenza won't have a vaccine ready for up to 6 months at best once it begins;
- Pandemic Influenza will overwhelm all known medical facilities and personnel rapidly;
- Pandemic Influenza is highly contagious and spreads to humans from animals;
- Pandemic Influenza will cripple national economies and industry by 40-50% easily;
- Pandemic Influenza can change it's proteins making immunization nearly impossible;
- Pandemic Influenza is lethal and will likely kill about 2,000,000 in America alone

No, this isn't science fiction, nor the paranoid ramblings of a tin-foil hat person on the internet.  These are facts that have been brought forth by the medical community (of which I do belong) as well as the US Department of Defense (DoD), Health & Human Services (HHS), Centers for Disease Control (CDC) and a multitude of other government agencies and private health related professional organizations.  Experts.  While there is no guarantee that we will see a Pandemic like we had in 1918, the odds are not on our side.  In fact, each day that we escape a pandemic, we are essentially on "borrowed time."  

It's not exactly known why these pandemics occur other than the fact that they often begin within the avian species (birds), and if conditions are just right, the virus infecting birds will have the correct DNA pattern to be zoonotic with the ability to "jump" species, meaning, it will jump from only infecting birds to infecting both birds and humans.  Once that happens, we are off to the races with a potential pandemic if quarantine measures are not effective in quelling the source.  Often this will result in a government stepping in and euthanizing infected poultry (a common vector for pandemic influenza) which can be devastating for farmers and the country's overall economy (to the tune of BILLIONS in lost revenue).  Knowing this, some nations might not want to volunteer information that their poultry could be infected, or may lack the scientific monitoring tools to identify specific pandemic strains quickly (if at all).

In the United States, there have been poultry infected with pandemic strains, as recently as 2014-2015, although to most reading this, they never even knew this happened.  While it may have made the local news, it stayed comfortably out of the limelight for whatever reasons in the evening news broadcasts.  Maybe that's a good thing, as the mention of pandemic influenza isn't exactly a comfortable topic to report, especially when all the facts are not in yet.  

Regardless, as we approach the 100-year point from the last major pandemic flu outbreak, we do at the very least have better medical facilities, better supportive medications and life-support equipment that simply didn't exist 100 years ago.  That isn't a guarantee for a positive outcome, however, it does flip the odds for at least some lucky individuals who may be in the first wave of those treated.  Those not in the first wave, may be simply out of luck as hospital beds and ventilators (the key piece of equipment needed to save lives from pandemic influenza) may very likely all be in use.  Below is the most recent Senate Hearing this year on U.S. capabilities to deal with Pandemic Flu and other medical crisis:

For those who are really want to know where we stand as a Nation in relation to Pandemic Flu, the below reports will be a good starting point.  They are all recent, 2017, and present accurately what likely scenarios are should America be faced with Pandemic Influenza.  In fact, these reports and hearings are starting to become more frequent in timing;  this is generally a sign that something may be looming, or at the very least, has the attention of those in the House and Senate to the point where they are seeking more and more information.  Congress won't usually do this unless they have reason to do so.  A brief summary of follows at the bottom of this page after these reports:

Pandemic Response / Emergent Threat Analysis by Scott Anthony on Scribd

The above is the report referenced in the DoD report to Congress, and it defines areas of the HHS Pandemic Plan that is in need of refining.  However, in 2014-2015 there was in fact a Highly Pathogenic Avian Influenza (HPAI) event within the United States.  It did not receive a lot of media attention.  In addition, the following year in 2016 a Low Pathogenic Avian Influenza (LPAI) event occurred also, with little media attention.  As a result, the following "RED BOOK" was devised and we are publishing it here for public knowledge.  Please note, this is a U.S. Government document, it is part of the National Emergency Response Plan, and this is how the Government will respond to further threats to the United States.  See below:

This is the most important article I have posted to date.  It is imperative that people are alert to the very real threat of HPAI / LPAI and what the potential consequences are to everyday life, and life in general.  Below is the actual report submitted to Congress on the detailed mitigation strategy used to contain the 2014-2015 event.

A novel influenza (flu) virus is an influenza A virus that has caused human infection and which is different from current human seasonal influenza A viruses. Any novel influenza A virus, such as those of avian or swine origin, has the potential to cause an influenza pandemic. Some novel flu A viruses are believed to pose a greater pandemic threat and are more concerning to public health officials than others because they have already caused serious human illness and death and also have been able to spread in a limited manner from person to person. Novel influenza A viruses are of extra concern because of the potential impact they could have on public health if they gained the ability to spread from person-to-person easily and thus trigger an influenza pandemic. Examples of novel influenza A viruses of extra concern because of their potential to cause a severe pandemic include avian influenza A (H5N1) and avian influenza A (H7N9) viruses. These two different avian influenza A viruses have caused sporadic human infections, some limited person to person spread and resulted in critical illness and death in people.

Different animals—including birds and pigs—are hosts to influenza A viruses that do not normally infect people. Influenza A viruses are constantly changing, making it possible on very rare occasions for non-human influenza viruses to change in such a way that they can infect people easily and spread efficiently from person to person.

Influenza viruses that normally circulate in pigs also have infected people; these viruses include influenza A (H1N1v), (H1N2v) and (H3N2v). When influenza viruses that normally circulate in swine are found in people, they are called “variant” viruses; the “v” after the virus name indicates a variant virus. Limited, unsustained spread from person to person also has been detected with these viruses, but in general, these variant viruses have been associated with less severe illness and fewer deaths than avian influenza viruses. In general, human infections with H5N1, H7N9, H1N1v, H1N2v and H3N2v viruses have occurred rarely, but if these viruses were to change in such a way that they were able to infect humans easily and spread from person to person in a sustained manner, a flu pandemic could result.

Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: the hemagglutinin (H) and the neuraminidase (N). There are 18 different hemagglutinin subtypes and 11 different neuraminidase subtypes (H1 through H18 and N1 through N11). Theoretically, any combination of the 18 hemagglutinins and 11 neuraminidase proteins are possible, but not all have been found in animals and even fewer have been found to infect humans.

Influenza viruses can change in two different ways, one of which is called “antigenic shift” and can result in the emergence of a new influenza virus. Antigenic shift represents an abrupt, major change in an influenza A virus. This can result from direct infection of humans with a non-human influenza A virus, such as a virus circulating among birds or pigs. Antigenic shift also can happen when a non-human influenza A virus (for example an avian influenza virus) exchanges genetic information with other influenza A viruses in a process called genetic reassortment, and the resultant new virus is able to infect people. For example, an exchange of genes between a human influenza A virus and an avian influenza A virus can create a new influenza A virus with a hemagglutinin protein or both a hemagglutinin protein and a neuraminidase protein from an avian influenza A virus. If this new virus causes illness in infected people and can spread easily from person to person, an influenza pandemic can occur.

When a pandemic influenza virus emerges, the virus can spread quickly because most people will not be immune and a vaccine might not be widely available to offer immediate protection. During the 2009 H1N1 pandemic, for example, a new H1N1 virus was first identified in April 2009. By June 2009, that novel H1N1 virus had spread worldwide and the World Health Organization declared a pandemic. Spread of a pandemic influenza virus may occur in multiple disease “waves” that are separated by several months. As a pandemic influenza virus spreads, large numbers of people may need medical care worldwide. Schools, childcare centers, workplaces, and other places for mass gatherings may experience more absenteeism. Public health and healthcare systems can become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and transportation industry may also be affected.

It is unlikely that seasonal flu vaccines would protect against a pandemic influenza virus. Seasonal flu vaccines that are used annually protect against currently circulating human influenza A and B viruses. They are not designed to protect against new influenza A viruses. A pandemic influenza virus would be very different from circulating seasonal influenza A viruses and thus seasonal vaccines would not be expected to offer protection.

The federal government has created a stockpile of some vaccines against select influenza A viruses with pandemic potential that could be used in the event of a pandemic, including vaccines against certain avian influenza A (e.g. H5N1 and H7N9) viruses. If a similar virus were to begin a pandemic, some vaccine would already be available.

The Department of Health and Human Services (HHS) is the lead agency for public health preparedness and medical response to an influenza pandemic. Within HHS, the Biomedical Advanced Research and Development Authority (BARDA) Influenza Division is charged with the advanced development and procurement of medical and non-pharmaceutical countermeasures for pandemic influenza preparedness and response.

If a new pandemic influenza virus (not included in the pre-pandemic vaccine stockpile) were to emerge, it is likely that a vaccine would have to be developed against that virus in order for sufficient supply of vaccine to become available for everyone who wishes to be vaccinated. How long it would take to produce a pandemic flu vaccine would depend on many factors, including how long it would take to create a candidate vaccine virus (CVV) and what vaccine manufacturing process would be used.” For seasonal influenza vaccine, it usually takes at least six months to produce large quantities of flu vaccineDuring the 2009 H1N1 pandemic, it took about the same amount of time. CDC began developing a CVV to make monovalent (one component) H1N1pdm09 vaccine in mid-April. The first doses of vaccine were administered in early October and large quantities of vaccine became available in late November. Efforts are underway now to shorten the time it takes to produce influenza vaccines but because of the current amount of time needed to make flu vaccine, early supplies of pandemic vaccine might not be enough to meet demand, especially if most people need two doses of vaccine for protective immunity.

CDC has developed an updated set of guidelines, called the Community Mitigation Guidelines to Prevent Pandemic Influenza – United States, 2017, supplemental plain-language guides for specific community groups, and online communication and education materials that outline strategies for planning and preparing for a flu pandemic and for using nonpharmaceutical interventions (NPIs). Additionally, CDC has developed an NPI 101 training for public health professionals to help them learn more about NPIs and share information with their communities on how to use NPIs.